chapter four

CHAPTER FOUR 4 Results: 4.1 Screening examination: In the present study, 5736 students were examined, and among them 260 students of them had Amblyopia. (4.53%)

Table (7) the number of the total students examined in the screening. Number students examined in the present study Amblyopic Percentage%

5736

260

4.53

The table No (7) shows that 4.53% of students in the present study had Amblyopia. This study shows that the amblyopia is a very important affliction, because late treatment may result in permanent vision loss in the affected eye.

4.2 Refractive error: Table (8) Refractive error in the present study Total No. students examined in the present study Number students with refractive error Percentage%

5736

1423

24.80

The table No. (8) Shows that the refractive error exist only in the 24.80% of student in the present study. And a result shows screening examination are needed every year in school. An essential and hardly preliminary part of the examination is determination of the refractive error of a patient to diagnosis of amblyopia. One must always strive to obtain as complete and accurate an estimate of the refractive error as possible. A refractive error is determined by two factors (1); the refractive power of the cornea and the lens and (2) the length of the eye. (36) In the present study refractive error include hypermetropia, myopia, astigmatism and mixed refractive errors .we use from the cycloplegic drops .Cycloplegic drops are used to place the eye in an unaccommodated rested state. The large pupil that results makes retinoscopy and ophthalmoscopy earner, but arrested accommodation is the main advantage of cycloplegic.Performing a refraction by retinoscopy in a young person without using cycloplegic drops has been likened to measuring a man for a suit of clothes while he is running down the street . (25)

4.3 Amblyopic eye in the present study: Table (9) Amblyopic eye in the present study No. Percentage% Amblyopic eye students from 5736 students

260

100

Examined again in hospital or clinic of optometry in massif

159

61.15

Did not come to examination to hospital or clinic of optometry 101

38. 85

Table (9). Shows that 260 pupils have amblyopia. We have told them to come to the hospital or the clinic to be treated, but 101 pupils ignored and did not come.

Figure (11) –Examined and did not examined in hospital. This indicates that some families ignore their children health .After we examined the case, we explained the danger of amblyopia and the need of treatment.We also send a massage to those families about this affliction and the importance of treatment. Diagnosis of amblyopia is very important, during the first six to nine years of life; the visual system develops very rapidly. Complicated connections between the eye and the brain are created .We do not yet have the technology to create these eye-to-brain connection in older children and adults. Diagnosis of amblyopia is a problem but treatment it is the most important. In this study we use from the screening tests and after that screening we again careful examination students with amblyopic eye, then refer them to the special examinations .

4.4 Sex (male and female): Table (10) Sex (male and female ) From=260 cases Sex Male

Cases Percentage % 119

45.77

Female 141

54.23

Table (10) shows that from 260 students had amblyopia, 119(45.77%) from them were male and 141 (54.23%) from them were female.

TA Figure (12) Female and male student in the present study

4.5 Causes of amblyopia: Table (11) Amblyopia causes in the present study. From = 260 Cases Causes

Cases Percentage %

Anisometropic amblyopia 209

80.38

Strabismic amblyopia

31

11.92

Deprivation amblyopia

17

6.54

Organic amblyopia

3

1.16

Table (11) shows that from 260 students that they had amblyopia, 209 (80.38%) from them had anisometropic amblyopia, 31 (11.92%) from them had strabimic amblyopia, 17 (6.54%) from them had deprivation amblyopia, 3 (1.16%) from them had organic amblyopia.

Figure (13) Causes of amblyopia in the present study

4.6 Age distribution: Table (12): Age distribution From = 159 cases Age (years) No. of cases Percentage % Range 6 -8

39

24.53

8-10

22

13. 84

10-12

41

25. 79

12-14

23

14. 46

14–16

34

21. 38

This table(12) shows the distribution of amblyopia according to the age of the patients. As we have shown before, from (159) pupils (39 pupils) 24.52% of them were between (6-8) years old .And they were needed to treatment. 22 of them (13.83%) were between (810)years old , 41 (25.78%) were between (10-12) years old . 23 ( 14.46%) were between (12-14)years old . 34 ( 21. 38%) were between (14-16)years old .

Figure (14) Age distribution

4.7 Bilaterality: Table (13): Bilaterality From: 159 cases No. Percentage %

Unilateral/amblyopia 128

80.50

Bilateral/amblyopia 31

19.50

The table (13) shows the unilateral amblyopia is more common than bilateral amblyopia. . 128(80.5%) students had unilateral amblyopia in the total of 159 students .And 31(19.49%) students had bilateral amblyopia from the same number.

Figure (15) Bilaterality

4.8 Side involved: Table (14): Side involved From: 159 cases Amblyopic Eye No. of cases Percentage % RE

59

37.11

LE

69

43.40

Bilateral

31

19.49

The table (14) shows that in the total of 159 students, 59 (37.11%) cases involved RE, and 69 (43.40%) cases involved LE, also 31 (19.49%) cases are bilateral amblyopia .

Figure (16) Side involved

4.9 First and previous examination: Table (15): First and previous examinations From = 159 Cases Number students Percentage First time examination

146

91.82

previous examination

13

8.18

%

This table( 15) Show that 146 (91.82%) pupils were examined for the first time. And 13 cases from 159 case (8.18%) were already examined.

Figure (17)the first and previous examinations Table (16): Already treated amblyopia (159) Already amblyopia therapy

No. Percentage %

Do not had amblyopia treatment 150

94.34

Have amblyopia therapy

5.66

9

According to this table, 150 (94.34%) cases from 159 cases don’t have treatment before, and 9 cases had previous amblyopia treatment.

Figure (18) already treated amblyopia

4.10 Anisometropia: Table (17): kinds of refractive error in the present study (anisometropia) From = 159 cases No. Percentage % Hypermetropia(simple) 36

22.64

Myopia (simple)

5.66

9

Astigmatism (simple) 22

13. 84

Mixed astigmatism

57. 86

92

The table no. (17) shows the following: 36 (24.64%) cases of 159 cases had hypermetopia. 9 (5.66%) case had myopia. 22(13.84%) cases had astigmatism. 92(57.96%) cases of 159 cases had mixed astigmatism.

Figure (19) Refractive errors

4.11 Strabismus: Table (18): Strabismus in the present study From = 159 Cases Tropia Unilateral/bilateral No Percentage % No Percentage % Unilateral

3

1.88

Bilateral

2

1.25

Unilateral

8

5. 03

Bilateral

7

4.40

Exotopia

Esotropia

5

3.14

15

9.43

The table (18) shows of that from 159 cases, 5 (3.14%) cases have exotropia and 15(9.43%) cases have esotropia.

Figure (20) Strabismus

4.12 Results of treatment of amblyopia: Table (19): Results of treatment amblyopia during the period of the present study. From = 159 Cases Result

No. Percentage %

VA =6/6

87

54.72

continue treatment

33

20. 76

No result treatment

15

9. 43

Did not come to continue treatment 24

15.09

The table (19) shows that 87 (54.72%) cases have visual acuity 6/6 after amblyopia therapy and they are good result, and 33(20.76%) cases are continuous on treatment . 15 (9.43%) cases shows no result to treatment . 24( 15.09%) cases did not come to be treated .

Figure (21) Results of amblyopia therapy

4.13 Amblyopia and dyslexia: Table (20): Amblyopia and Dyslexia in the present study. From =159 Cases

Bilateral amblyopia = 31 Unilateral amblyopia=128 Dyslexia = 4 /Agraphia = 25

Dyslexia =0 / Agraphia=3

This table shows that in the total of 159 cases which had amblyopia, only 128 cases had unilateral amblyopia and none of them had dyslexia .3 cases had agraphia. In 31 cases of bilateral amblyopia only 4 cases had dyslexia and 25 cases had agraphia.

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